Transfers from residential aged care facilities to the emergency department are reduced through improved primary care services: An intervention study

Aim: To assess the impact of an enhanced primary care service for residential aged care facilities (RACF) on the transfer of patients from RACF to a hospital emergency department (ED). Methods: A before-after study of an enhanced primary care service provided by experienced ED-based nurses under the governance of general practitioners. The intervention was analysed comparatively using standardised normal deviates and seasonal autoregressive integrated moving average models, complemented by qualitative assessment. Results: There was a statistically significant reduction (17%, P < 0.001) in the number of transfers during the intervention period. This finding held when adjusting for the seasonality of ED referrals over a 4-year period. The intervention was highly valued by clinicians in RACF and ED. Conclusion: Enhanced primary care services reduce the number of transfers to ED from RACF.